Fj. Gallegorojo et al., BONE-MINERAL DENSITY, SERUM INSULIN-LIKE-GROWTH-FACTOR-I, AND BONE TURNOVER MARKERS IN VIRAL CIRRHOSIS, Hepatology, 28(3), 1998, pp. 695-699
Previous studies suggest that low bone mass is a complication of alcoh
olic liver disease. Nevertheless, little is known about bone mass and
bone metabolism in viral cirrhosis. To evaluate the prevalence and mag
nitude of hepatic osteopenia in these patients, bone remodeling status
, and its relationship with the severity of liver disease and serum le
vels of insulin-like growth factor I (IGF-I), we studied 32 consecutiv
e patients with viral cirrhosis and no history of alcohol intake. Bone
mineral density (BMD) was measured by dual x-ray absorptiometry in th
e lumbar spine (LS) and femoral neck (FN), and the values were express
ed as the z score. Bone metabolism markers and hormone profiles were m
easured. Patients with viral cirrhosis showed reduced BMD in all sites
(LS: -1.27 +/- 1.06, P < .001; FN: -0.48 +/- 0.96; P < .01). Of the 3
2 patients, 53% met the diagnostic criteria for osteoporosis. In patie
nts, urine deoxypyridinoline (D-Pyr) as a marker of bone resorption an
d serum bone alkaline phosphatase (b-AP) as a marker of bone formation
were significantly higher than in control subjects (P < .001 and P <
.01, respectively). Serum IGF-I was lower than in control subjects (P
< .001), and significant differences were also found between patients
with and without osteoporosis (P < .05), BMD in LS correlated with sev
erity of the disease, with serum levels of IGF-I, and with urine D-Pyr
, Our findings show that viral cirrhosis is a major cause of osteoporo
sis in men, and that low serum IGF-I levels seem to play a role in the
bone mass loss in these patients. The biochemical markers of bone rem
odeling suggest high-turnover osteoporosis in patients with viral cirr
hosis.